Patterns of counseling techniques used by family practice physicians for smoking, weight, exercise, and stress

Members of the American Academy of Family Physicians (nonfederal, continental U.S.) were surveyed regarding their involvement in health-habit modification (response rate = 70.4%, n = 903). Frequency and indications for use of specific counseling techniques were assessed in each of four health-habit areas: smoking, exercise, weight control, and stress management. Factor analysis of responses produced clusters of techniques labeled "traditional teaching," "behavioral," "interpersonal with follow-up," and "referral." The dominant style varied by health-habit area. The factors were less clear for stress than for the other three areas. Results indicated no relationships or weak relationships between counseling approaches and physician gender, year of graduation, board status, region, community size, practice type, average visit length, and selected patient characteristics. Study findings suggest that family physician counseling varies with the health habit and that background and practice variables are not associated with counseling approach.